Tag Archives: weight loss

Nuttin’ But Salads N=1 Experiment: Week 17 Summary and Wrap-Up

Not a salad, but a sunrise from my hospital in the Sonoran desert

It’s over. Four months of mostly nothing but salads.

I wanted to lose some weight. I started at 175.5 lb (79.8 kg) and have ended at 162 lb (73.6 kg). So call it down 13 pounds. Not quite a stone (14 lb), as they say in England.

No regrets. It’s been fun, an adventure, especially since my wife was involved. My suit pants fit again. My family bought me an expensive sturdy belt that will support my holster, and it fits for the first time.

As a reminder: I’ve just been eating twice daily, without snacking in-betweeen meals. Compared to thrice daily meals plus snacking, twice daily meals makes more sense to me from an evolutionary and physiological viewpoint. Eating just twice daily may increase autophagy.

What’s Next?

Avoiding weight regain! And trying to maintain or improve my health as I age. I feel like I’ve really been “eating healthy.” My plan is to continue eating just two meals a day, one of which will be a gourmet salad. The other will include animal proteins, cooked vegetables, legumes, and fruit. I tend to prefer low-carb types of fruits and vegetables.

High Blood Pressure

I don’t remember if I’ve shared with you the effect of this diet on my blood pressure. Starting in January 2017, my blood pressures were hitting 160/110, 150/100 more commonly. Sometimes 170 systolic. For a few years before that, pressures were borderline high. I’m old school, so tend to define hypertension as 140/90 or higher on multiple occasions. In 2017, the American Heart Association re-defined hypertension as pressures over 130/80.  Those numbers make half of the U.S. adult population hypertensive and candidates for drug therapy! And it runs in my family.

That’s more like it…

I started an antihypertensive drug, amlodipine, in late December  2017. Before that, I tried magnesium supplements and hibiscus tea: no help. I reduced alcohol consumption: no help. My amlodipine dose initially was 5 mg/day, then 10 mg/day. The higher dose caused some minor but definite swelling in my feet. To decrease the swelling (edema), I reduced the dose to 5 mg/day. On Feb 6, 2018, I started this Nuttin’ But Salads experiment. That dose reduction indeed reduced my edema. On Feb 12, my records show the lower dose still controlling my pressure.

After nine weeks of the Nuttin’ But Salads experiment, I noticed my pressures were 120/85 or lower. I stopped amlodipine April 9. By April 21, pressures were rising a little but no higher than 130/90. Edema gone almost immediately.

My Omron unit

As I write this, my BP after a 12-hr shift at the hospital is 124/91. The recent average is about 130/92. Not great, but I’m happy with it and not inclined to go back on drug therapy.

Screenshot of the free Health app on my iPhone

Why is my BP lower now? It may well be the salad diet. But also consider my weight loss or much lower alcohol consumption. I’m still drinking hibiscus tea and taking a magnesium supplement, but I was doing that before the salad experiment. I’ll also admit my stress levels may be lower, too.

One of these days I’ll do a nutrient analysis of my salad diet and probably share it with you. I’d love to know if others would see reduced blood pressure with this way of eating, whether or not weight loss was involved or needed.

Steve Parker, M.D.

P.S. I wouldn’t be surprised if my diet has been “deficient” in calcium and vitamin D. Whether or not that matters is another issue.

Do Wearable Activity-Trackers Help With Weight Loss?

“Wearable devices that monitor physical activity are not reliable tools for weight loss, says a new study from the University of Pittsburgh School of Education’s Department of Health and Physical Activity. The study specifically investigated whether regular use of commercially available activity trackers is effective for producing and sustaining weight loss.

At the conclusion of a 24-month trial, researchers observed that usage of a wearable device in combination with a behavioral weight loss program resulted in less weight loss when compared to those receiving only the behavioral weight loss program. In fact, participants without physical activity trackers showed nearly twice the weight loss benefits at the end of the 24 months. Participants who utilized wearable devices reported an average weight loss of 7.7 pounds, while those who partook only in health counseling reported an average loss of 13 pounds.”

Source: Activity trackers are ineffective at sustaining weight loss — ScienceDaily

Are Diet Beverages OK When You’re Trying to Lose Weight?

Overweight and obese women who habitually drank diet beverages lost more weight if they substituted water for the diet beverage. Over the course of 24 weeks on a reduced calorie diet, the water drinkers lost an extra 1.2 kg (2.6 lb) compared to those who continued their diet beverage habit.

Furthermore, the researchers found that the water drinkers had healthier values on insulin levels, HOMA-IR (a measure of insulin resistance), and after-meal blood sugar levels.

It was a small study with only about 30 in each experimental group. Whether similar results would be seen in men is unknown to me.

In the past, I’ve advised dieters it’s OK to drink diet drinks in moderation while trying to weight. I may have to revise my recommendations. On the other hand, if diet drinks help keep you happy and on a successful weight-loss journey, they may be helpful. The diet beverage consumers still lost 7.6 kg (16.7 lb) compared with 8.8 kg (19.4 lb) in the abstainers. But diets don’t work, right?

Steve Parker, M.D.

PS: I haven’t read the full text of the article; just the abstract.

PPS: Steven Novella at Science-Based Medicine blog concludes that low energy sweeteners probably help with weight control.

For Seniors on a Weight-Loss Diet, Resistance Training Beats Aerobics for Bone Preservation

according to an article at MedPageToday.

"One more rep then I'm outa here!"

“One more rep then I’m outa here!”

The two experimental groups had about 60 participants each, so it was a relatively small study. (In general, the larger the study, the more reliable the findings.) Most participants were white women; mean age was 69. The experimental intervention ran for five months. An excerpt:

In one trial, the participants were randomized to a structured resistance training program in which three sets of 10 repetitions of eight upper and lower body exercises were done 3 days each week at 70% of one repetition maximum for 5 weeks, with or without calorie restriction of 600 calories per day.
In the second study, participants were randomized to an aerobic program which was conducted for 30 minutes at 65% to 70% heart rate reserve 4 days per week, with or without calorie restriction of 600 calories per day.

The beneficial bone effect was seen at the hip but not the lumbar spine.

Thin old bones—i.e., osteoporotic ones—are prone to fractures. Maintaining or improving bone mineral density probably prevents age-related fractures. In a five-month small study like this, I wouldn’t expect the researchers to find any fracture rate reduction; that takes years. 

Most elders starting a weight-training program should work with a personal trainer.

Steve Parker, M.D.

Expert Weight-Loss Tips

1.  Record-keeping is often the key to success.

2.  Accountability is another key to success. Consider documenting your program and progress on a free website such as FitDay, SparkPeople, 3FatChicks, Calorie Count (http://caloriecount.about.com), or others. Consider blogging about your adventure on a free platform such as WordPress or Blogger. Such a public commitment may be just what you need to keep you motivated.

3.  Do you have a friend or spouse who wants to lose weight? Start the same program at the same time and support each other. That’s built-in accountability.

4.  If you tend to over-eat, floss and brush your teeth after you’re full. You’ll be less likely to go back for more anytime soon.

5.  Eat at least two or three meals daily. Skipping meals may lead to uncontrollable overeating later on. On the other hand, ignore the diet gurus who say you must eat every two or three hours. That’s codswallop.

6.  Eat meals at a leisurely pace, chewing and enjoying each bite thoroughly before swallowing.

7.  Plan to give yourself a specific reward for every 10 pounds (4.5 kg) of weight lost. You know what you like. Consider a weekend get-away, a trip to the beauty salon, jewelry, an evening at the theater, a professional massage, home entertainment equipment, new clothes, etc.

8.  Carefully consider when would be a good time to start your new lifestyle. It should be a period of low or usual stress. Bad times would be Thanksgiving day, Christmas/New Years’ holiday, the first day of a Caribbean cruise, and during a divorce.

9.  If you know you’ve eaten enough at a meal to satisfy your nutritional requirements yet you still feel hungry, drink a large glass of water and wait a while.

10  Limit television to a maximum of a few hours a day.

11.  Maintain a consistent eating pattern throughout the week and year.

12.  Eat breakfast routinely.

13.  Control emotional eating.

14.  Weigh frequently: daily during active weight-loss efforts and during the first two months of your maintenance-of-weight-loss phase. After that, cut back to weekly weights if you want. Daily weights will remind you how hard you worked to achieve your goal.

15.  Be aware that you might regain five or 10 pounds (2-4 kg) of fat now and then. You probably will. Don’t freak out. It’s human nature. You’re not a failure; you’re human. But draw the line and get back on the old weight-loss program for one or two months. Analyze and learn from the episode. Why did it happen? Slipping back into your old ways? Slacking off on exercise? Too many special occasion feasts or cheat days? Allowing junk food or non-essential carbs back into the house?

16.  Learn which food item is your nemesis—the food that consistently torpedoes your resolve to eat right. For example, mine is anything sweet. Remember an old ad campaign for a potato chip: “Betcha can’t eat just one!”? Well, I can’t eat just one cookie. So I don’t get started. I might eat one if it’s the last one available. Or I satisfy my sweet craving with a diet soda, small piece of dark chocolate, or sugar-free gelatin. Just as a recovering alcoholic can’t drink any alcohol, perhaps you should totally abstain from…? You know your own personal gastronomic Achilles heel. Or heels. Experiment with various strategies for vanquishing your nemesis.

17.  If you’re not losing excess weight as expected (about a pound or half a kilogram per week), you may benefit from eating just two meals a day. This will often turn on your cellular weight-loss machinery even when total calorie consumption doesn’t seem much less than usual. The two meals to eat would be breakfast and a mid-afternoon meal (call it what you wish). The key is to not eat within six hours of bedtime. Of course, this trick could cause dangerous hypoglycemia if you’re taking drugs with potential to cause low blood sugars, like insulin and sulfonylureas. If you take drugs for diabetes, talk to your dietitian or physician before instituting a semi-radical diet change like this.

18.  One of the bloggers I follow is James Fell. He says, “If you want to lose weight you need to cook. Period.” James blogs at http://www.sixpackabs.com, with a focus on exercise and fitness.

19.  Regular exercise is much more important for prevention of weight regain rather than for actually losing weight.

Steve Parker, M.D.

 

Just What We Needed, Right? Americans Have a New Weight-Loss Drug: Saxenda

Well, it’s not entirely new. It’s liraglutide, which has been available to treat diabetes for a several years, sold in the U.S. as Victoza. Click for my brief review of the drug class for diabetics.

Click for the CBS News report on Saxenda. A snippet:

One clinical trial that involved patients without diabetes found that patients taking Saxenda had an average weight loss of 4.5 percent after one year. Of the people treated with the drug, 62 percent lost at least 5 percent of their body weight. Meanwhile, only 34 percent of those given an inactive placebo had the same result.

Another clinical trial that included patients with type 2 diabetes found that patients had an average weight loss of almost 4 percent after one year. Of those given Saxenda, 49 percent lost at least 5 percent of their body weight, compared to 16 percent of those who were given a placebo treatment.

Click for the FDA’s press release.

Oh, by the way. You have to inject it daily under the skin (subcutaneous). And if you were hoping for a shortcut to weight loss, this isn’t it. You’re still supposed to follow a reduced-calorie diet and exercise regularly.

I’d try The Advanced Mediterranean Diet first.

Steve Parker, M.D.

PS: Full prescribing information.

New Weight Loss Drug, Contrave, May Work But Also Cause Suicidal Thoughts

"These are flying off the shelves!"

“This’ll fix you right up!”

The FDA recently approved a new weight-loss drug for the U.S. market. It’s marketed as Contrave, a combination of naltrexone and bupropion.

Neither of the components is new. Naltrexone’s been used to treat alcohol and narcotic addiction. Bupropion, e.g., Wellbutrin, is for depression and smoking cessation.

Contrave joins two other recent drugs for weight loss. Belviq and Qsymia were approved in 2012. I still haven’t run across anyone using those.

To qualify for the new formulation, you need a body mass index over 30, or over 27 plus one or more weight-related medical condition such as type 2 diabetes or high blood pressure.

If you haven’t lost over 5% of your initial body weight in the first 12 weeks of use, the FDA recommends stopping the drug.

Potential adverse effects include suicidal thoughts and seizures. More commonly, users may experience headache, nausea, constipation, diarrhea, dizziness, insomnia, and dry mouth. Constipation and diarrhea?!

Even with the drug, you still have to be on a reduced-calorie diet and exercise program.

Why not try the Advanced Mediterranean Diet or Ketogenic Mediterranean Diet first?

Steve Parker, M.D.